Evidence map›Paper›PMID 35609229›Full record

ArticleJCO global oncology2022

Techno-Economic Feasibility Analysis of a Fully Mobile Radiation Oncology System Using Monte Carlo Simulation.

Alex T Price, Casey Canfield, Geoffrey D Hugo, James A Kavanaugh, Lauren E Henke, Eric Laugeman, Pamela Samson, Clair Reynolds-Kueny, Elizabeth A Cudney

Open access · goldAbstract read
In one paragraph

Article in JCO global oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.3field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Alex T PriceDepartment of Radiation Oncology, Washington University School of Medicine in St Louis, St Louis, MO.ORCID 0000-0002-9054-6474
Casey CanfieldDepartment of Engineering Management and Systems Engineering, Missouri University of Science and Technology, Rolla, MO.ORCID 0000-0001-5325-3798
Geoffrey D HugoDepartment of Radiation Oncology, Washington University School of Medicine in St Louis, St Louis, MO.ORCID 0000-0002-4109-8177
James A KavanaughDepartment of Radiation Oncology, Washington University School of Medicine in St Louis, St Louis, MO.ORCID 0000-0001-6001-914X
Lauren E HenkeDepartment of Radiation Oncology, Washington University School of Medicine in St Louis, St Louis, MO.ORCID 0000-0003-2208-3241
Eric LaugemanDepartment of Radiation Oncology, Washington University School of Medicine in St Louis, St Louis, MO.ORCID 0000-0002-4362-3182
Pamela SamsonDepartment of Radiation Oncology, Washington University School of Medicine in St Louis, St Louis, MO.ORCID 0000-0003-2448-2123
Clair Reynolds-KuenyDepartment of Psychological Science, Missouri University of Science and Technology, Rolla, MO.ORCID 0000-0003-0951-4326
Elizabeth A CudneySchool of Business, Maryville University, St Louis, MO.ORCID 0000-0002-3990-0474
Washington University in St. Louis · USMissouri University of Science and Technology · USMaryville University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDisparities in radiation oncology (RO) can be attributed to geographic location, socioeconomic status, race, sex, and other societal factors. One potential solution is to implement a fully mobile (FM) RO system to bring radiotherapy to rural areas and reduce barriers to access. We use Monte Carlo simulation to quantify techno-economic feasibility with uncertainty, using two rural Missouri scenarios.

methodsRecently, a semimobile RO system has been developed by building an o-ring linear accelerator (linac) into a mobile coach that is used for temporary care, months at a time. Transitioning to a more FM-RO system, which changes location within a given day, presents technical challenges including logistics and quality assurance. This simulation includes cancer census in both northern and southeastern Missouri, multiple treatment locations within a given day, and associated expenditures and revenues. A subset of patients with lung, breast, and rectal diseases, treated with five fractions, was simulated in the FM-RO system.

resultsThe FM-RO can perform all necessary quality assurance tests as suggested in national medical physics guidelines within 1.5 hours, thus demonstrating technological feasibility. In northern and southeastern Missouri, five-fraction simulations' net incomes were, in US dollars (USD), $1.55 ± 0.17 million (approximately 74 patients/year) and $3.65 USD ± 0.25 million (approximately 98 patients/year), respectively. The number of patients seen had the highest correlation with net income as well as the ability to break-even within the simulation. The model does not account for disruptions in care or other commonly used treatment paradigms, which may lead to differences in estimated economic return. Overall, the mobile system achieved a net benefit, even for the most negative simulation scenarios.

conclusionOur simulations suggest technologic success and economic viability for a FM-RO system within rural Missouri and present an interesting solution to address other geographic disparities in access to radiotherapy.

Indexed as

Radiation OncologyComputer SimulationFeasibility StudiesHumansMonte Carlo MethodParticle Accelerators

Identifiers

PMID35609229
PMCPMC9173580
OpenAlexW4281636564

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.